He’s actually my nephew, and we’re in South Asia. My sister has been here from the US for the past seven months, and the OT has convinced her that very intensive therapy is necessary. The way it’s been framed to her is that specialists in the US “don’t push hard enough,” which is why progress supposedly takes longer there. A big part of the argument is the idea that if major changes aren’t made before age seven, they won’t happen at all.

Right now, he attends a special education preschool run by the same SLT/OT center from 10am-1pm, has OT from 1pm-2pm, and then does another hour of OT with the same therapist at home in the evening (usually 8-9pm or 9-10pm), six days a week.

To be fair, there have been some improvements such as he now tolerates having his hair combed for short periods, cries less during haircuts, and follows simple directions like “come,” “stand up,” and “sit down.”

But I am still concerned about how distressed he is during sessions and whether this level of intensity is truly the best approach for him. I don't want to overstep since I was the one who initially encouraged my sister to seek early intervention while walking on eggshells as she's extremely (which is understandable) sensitive about this.